Maximum Medical Improvement (MMI) and Your Virginia Workers Compensation Claim


Workers compensation has many acronyms. If you have an accepted workers’ compensation claim and have been receiving wage loss benefits, then you’ve probably heard the term “MMI” from the claims adjuster or your attorney.


Reaching MMI is an important milestone. We recommend contacting experienced workers compensation attorney Corey Pollard to determine what additional benefits you’r entitled to after you reach MMI and to help you negotiate a lump sum workers comp settlement.


What Does MMI Stand For?


MMI stands for maximum medical improvement.


Simply put your doctor will say that you’ve reached maximum medical improvement when you’re as good as you’re going to get. MMI doesn’t mean that you’ve recovered completely and are back to normal. Rather, it means that your work injuries have stabilized and that further functional improvement is unlikely with additional medical treatment or physical therapy. In other words, you reach MMI when your injuries have plateaued and no other medical treatment will help you heal.


The more severe your injury, the longer it may take to reach maximum medical improvement. Injured employees who suffer minor injuries, such as sprains and bruises, will reach maximum medical improvement quickly because surgery is not required. Injured employees who suffer traumatic brain injuries, amputations, and fractures will require extensive medical care and take longer to reach MMI.


What Happens When I Reach MMI in My Workers Compensation Case?


Your Virginia workers’ compensation claim does not end when you reach MMI. Depending on whether you’re under an open award for temporary total disability benefits, reaching maximum medical improvement may signal that it is time to file a claim for permanent partial disability benefits or to try to negotiate a workers compensation settlement. MMI is when the parties know the long term effects of the work accident and what the future may hold.


Only a licensed doctor or osteopath can determine that you’ve reached MMI and the date that you did. Tell your attorney right away if your doctor says that you’ve reached MMI.


Your attorney should send a letter to your doctor that explains how permanent disability is evaluated under Virginia workers’ comp and requesting an evaluation and disability report.


The report given after you reach MMI should contain three things:


  • The date you reached MMI.


  • A permanent partial disability impairment rating that states the percentage loss of use and function of the injured body part because of the work accident. You have a functional impairment when the normal function of your body is at less than 100 percent because of your work injury. Impairment ratings must comply with the AMA Guides to the Evaluation of Permanent Impairment.


  • Your permanent work restrictions, or the job tasks that you are no longer able to perform because of the injuries you suffered in the work accident. Your disability, or work restrictions, is different from your impairment, which is the percentage loss of use of the body part on a scale from 0 to 100 percent.


For example a nurse or construction worker who injured their back at work may receive permanent restrictions that include no lifting more than 20 pounds and only 2 hours standing and walking each work day. Such restrictions would prevent the nurse or construction worker from returning to their pre-injury employment. If you’re unable to return to your pre-injury employment after reaching MMI, the potential value of your workers’ compensation settlement increases. This is because the employer must determine if it wants to settle, to continue paying wage loss benefits, or to pay for vocational rehabilitation so that you can transfer your skills to light duty work.


What if I Disagree with My Doctor’s Determination that I’ve Reached Maximum Medical Improvement?


Sometimes doctors throw in the towel too early and state that a patient has reached MMI even though there may be other treatment or surgical procedures that could improve the patient’s condition. If you think you fit into this category you have three options:


  • Use your private health insurance, if you have it, to make an appointment with a specialist for a second opinion.


  • Ask your treating physician to give you a referral for a second opinion.


  • File a claim with the Virginia Workers’ Compensation Commission seeking a second opinion.


Contact an experienced workers compensation lawyer in Richmond VA when weighing your options. You don’t want to make a decision that could lead to forfeiture of future workers’ compensation benefits.


What if My Injuries, Condition, and Symptoms Get Worse after I’ve Reached MMI?


I’ve represented many injured employees whose symptoms worsened after their doctor told them they had reached MMI. This is why I suggest waiting at least three months before filing a claim for permanent partial disability benefits.


Three months is often enough time to determine whether you can maintain full-time employment within your permanent work restrictions. If you’re able to return to light duty work with no problem, then it makes sense to file a claim for PPD benefits or to try to negotiate a lump sum settlement. If you continue to have problems and your symptoms worsen even though you’re working light duty, you should make a follow up appointment with your doctor.


An Attorney to Guide You When You’ve Reached MMI in Virginia


Reaching MMI is one of the most important milestones in workers’ compensation claims. After you’ve reached MMI an attorney can help you determine the following:


  • What type of vocational rehabilitation will help you get back into the labor market


  • The projected value of future wage loss


  • Your level of permanent impairment


  • The potential value of your workers comp settlement


  • Whether you may qualify for SSD benefits or SSI based on your age, education, and past work. I’m also a Richmond disability lawyer who represents injured workers in VWC and SSD claims.


Call or e-mail us today for help maximizing the value of your workers comp claim after you’ve reached MMI.